Karen Willard, LCDC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

12199 Issued in TX

Practice address

1510 S Vine Ave
Tyler, TX 75701-2826

Phone

(903) 526-4055

NPI assigned

Jul 3, 2018

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Methadone Clinic of East Texas LLC

  • Methadone Clinic
  • Tyler, TX
  • NPI 1104144088
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1530576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530576000000",
    "number": "1992291801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1764",
            "city": "LINDALE",
            "state": "TX",
            "postal_code": "757711764",
            "telephone_number": "903-952-8431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 S VINE AVE",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757012826",
            "telephone_number": "903-526-4055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLARD",
        "first_name": "KAREN",
        "credential": "LCDC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-03",
        "last_updated": "2018-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "12199",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Harry Lee Wilkerson, M.D.
• Jessica Wilkin, M.D.
• Caitlin Nicole Wilkins, ATC, LAT
• Megan Wilkins, CCC-SLP
• Will J Parks DDS MD PA
• Kimberly Willhite
• William E. Brown, M.D., P.a.
• William Hopson DC PC
• Aaron Williams, M.D.
• Aaron M. Williams, LPC

• Addiction (Substance Use Disorder) Counselor in Tyler, TX
• Providers in Tyler, TX by specialty
• Addiction (Substance Use Disorder) Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.